Judge rules on 'Do Not Resuscitate' case

A judge has ruled against a further hearing in a case involving a terminally-ill woman who was not consulted before a “do not resuscitate” (DNR) notice was placed on her medical records.

Earlier this week, Mrs Justice Nicola Davies said the failure to inform or involve 63-year-old Janet Tracey had "minimal causative effect", as the notice was cancelled five days later when her family objected, and not acted upon.

On that occasion, the doctor involved did consult Mrs Tracey's daughter and believed she had agreed to the notice.

The judge also found that a second notice, which followed three days afterwards and two days before Mrs Tracey's death, was put in place with the agreement of her family, who were unwilling to speak to her about it.

Today, the judge said it would be neither "appropriate nor proportionate", in the light of those limited findings of fact, to have a judicial review hearing on the legal issues, which would also involve the Health Secretary.

She refused permission to appeal but lawyers for Mrs Tracey can pursue the application directly with the Court of Appeal.

They want a judicial review to clarify whether there is a legal duty to inform patients with capacity whether a DNR has been placed on their notes and whether they have any right to be consulted about it.

Mrs Tracey, a care home manager, died in March last year following a transfer to Addenbrooke's Hospital, Cambridge, after breaking her neck in a car crash on February 19 - two weeks after being diagnosed with terminal lung cancer.

The first notice, on February 27, was cancelled on March 2, while a second was imposed on March 5, two days before she died.

Urging the go-ahead for a judicial review, Philip Havers QC said the issue was not academic but of real concern to many patients, their relatives and doctors.

Lord Faulks QC, for the trust, said there was certainly a public interest in such delicate and sensitive matters but that did not justify the court involving itself in rewriting policy.

Giving her ruling today, the judge said such a hearing would involve the court grappling with issues of policy and clinical decision-making on the basis of limited evidence.

The public interest would not be served by embarking upon a wide-ranging inquiry on such a basis.